Republic of the Philippines

BATANGAS STATE UNIVERSITY

The National Engineering University
Pablo Borbon Campus
Rizal Avenue Ext., Batangas City, Batangas, Philippines 4200
Tel No.: (043) 980-0385 local 1128
E-mail Address: cte.pb@g.batstate-u.edu.ph | Website Address: http://www.batstate-u.edu.ph

Dear respondents,

The researcher is a student of Master of Arts in Education major in Psychology and is conducting a study
on “Academic Self-concept and Academic Performance of Junior High School Students.” Your
assistance and cooperation are highly sought to help the researcher obtain the degree. Rest assured
that your responses will be treated with the utmost confidentiality and will only be used for the
purposes of this study.

Voluntary Participation. Participation in this study is entirely voluntary. There will be no negative
consequences if you choose not to participate. You may withdraw from the study at any time by
notifying the researcher. If you stop, all of the information you shared will be excluded from the study.

Privacy Protection. As a student – researcher, I put a premium value on the privacy and security of the
personal data entrusted by the respondents. In line with this, I aim to comply with the Date Privacy Act
of 2012 also known as the Republic Act of 10173. Following the Philippine Data Privacy Act of 2012 (RA
10173) which is a policy protecting the fundamental human right of privacy, of communication while
ensuring the free flow of information to promote innovation and growth, the data collected will be used
only for the purpose the research and other related academic purposes. I, the researcher will ensure the
privacy of the information that you will give in your participation in this study. All the details provided in
this study will be kept confidential and be used solely for the purpose of research. The researcher will
make every effort to preserve your confidentiality. Researchers will not use personal data for any
purpose other than that for which consent was given, respecting respondent’s wishes about using the
information. This informed consent will serve as permission to use your responses and given information
in the study.

Wennie Constantino – Albania

PART I. RESPONDENT’S PROFILE

Name (optional):_____________________________________
Age: ( )12 -14 ( ) 15-17
Sex: ( ) Male ( ) Female
Grade Level: ( ) Grade 7 ( ) Grade 8 ( ) Grade 9 ( ) Grade 10

PART 2. LEVEL OF ACADEMIC SELF-CONCEPT

Direction: Please check (/) one of the five options in the right-hand columns, representing varying
degrees of agreement with the statements made in the questions below, ranging from (1) "Strongly
Disagree" to (4) "Strongly Agree." The information you provide will be treated with the strictest
confidence.
(The column for the responses were changed to accept, revise, reject and remarks for the purpose of
validation)

Leading Innovations, Transforming Lives, Building the Nation

 Republic of the Philippines
BATANGAS STATE UNIVERSITY
The National Engineering University
Pablo Borbon Campus
Rizal Avenue Ext., Batangas City, Batangas, Philippines 4200
Tel No.: (043) 980-0385 local 1128
E-mail Address: cte.pb@g.batstate-u.edu.ph | Website Address: http://www.batstate-u.edu.ph

Math Academic Self – Concept

STATEMENT (MATHEMATICS) Accept Revise Reject Remarks
1. I find many Mathematical problems
interesting and challenging.
2. I have never been very excited about
Mathematics. *
3. I only learn Math when it is required*
4. I am able to do better than my friends in
Math.
5. I enjoy working out new ways of solving
Math problems.
6. I have good knowledge in Mathematical
concept.
7. I have never felt capable of learning
Mathematics. *
8. I always seek assistance in Mathematics
from my friends. *
9. I feel that I am knowledgeable in numbers.
10. I am hesitated to take courses that involve
Mathematics. *

STATEMENT (SCIENCES) Accept Revise Reject Remarks

1. I can easily follow experimental
instructions.
2. I have a tendency to generate incorrect
hypotheses. *
3. I am fascinated by the study of life cycles.
4. I am curious about what's in the natural
world and how it works.
5. I am not good in interpreting data. *
6. I find it difficult to analyze results. *
7. I can identify and solve scientific problems.
8. I enjoy learning science because it
challenges my assumptions about the
world.
9. I struggle to conduct scientific
investigations. *
10. I don’t do well in my science classes. *

Verbal Academic Self – Concept

STATEMENT (ENGLISH) Accep
Revise Reject Remarks
t

Leading Innovations, Transforming Lives, Building the Nation

 Republic of the Philippines
BATANGAS STATE UNIVERSITY
The National Engineering University
Pablo Borbon Campus
Rizal Avenue Ext., Batangas City, Batangas, Philippines 4200
Tel No.: (043) 980-0385 local 1128
E-mail Address: cte.pb@g.batstate-u.edu.ph | Website Address: http://www.batstate-u.edu.ph

1. I am good at communicating my ideas.

2. I can write effectively.
3. I have a poor English vocabulary. *
4. I'm having trouble identifying the text's
main/key ideas.
5. I have good reading comprehension.
6. I have a good understanding of literature
and other types of texts for a deeper
appreciation of Philippine culture and that
of other countries.
7. I need to work on my grammar. *
8. I had more trouble learning to read than
most other students. *
9. I can speak English fluently.
10. I'm usually confused by how words change
form and combine with other words to
form sentences.

STATEMENT (FILIPINO) Accep

Revise Reject Remarks
t
1. I can easily analyze Filipino written stories
and react to them.
2. I am always outspoken about my opinions
in Filipino Language.
3. I have a good Filipino words vocabulary.
4. I find it easy to understand Filipino
reading materials.
5. I know how to use proper punctuation
mark in Filipino context.
6. I have the ability to express myself in
Filipino language.
7. I accurately use proper grammar in my
Filipino writing.
8. I can explain the meanings of words from
stories I've read in Filipino language.
9. I can write well in Filipino.
10. I find it is easy to follow instructions in
Filipino Language.

STATEMENT (ARALING PANLIPUNAN) Accept Revise Reject Remarks

1. I have good knowledge in history.
2. I am very good at analyzing a series of
events.
3. I find it easy to interpret maps.
4. I understand the differences of culture

Leading Innovations, Transforming Lives, Building the Nation

 Republic of the Philippines
BATANGAS STATE UNIVERSITY
The National Engineering University
Pablo Borbon Campus
Rizal Avenue Ext., Batangas City, Batangas, Philippines 4200
Tel No.: (043) 980-0385 local 1128
E-mail Address: cte.pb@g.batstate-u.edu.ph | Website Address: http://www.batstate-u.edu.ph

among countries.
5. I am confident in joining debates using my
history knowledge.
6. I can tell the differences between false
and factual information.
7. I can interpret historical sources.
8. I can relate past to current events.
9. I can defend an argument.
10. I know how to research factual
information.

Thank you for your participation and God bless!

Leading Innovations, Transforming Lives, Building the Nation